The Endoscopic Removal of a Gastric Bezoar Made of Sodium Zirconium Cyclosilicate Hydrate.
Katsuma Yamauchi, Aya Kitae, Masayuki Hara et al.
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Case in brief
A 77-year-old woman receiving intensive care for acute adrenal insufficiency developed a 37-mm gastric bezoar after sodium zirconium cyclosilicate hydrate (SZC) was administered through a nasogastric tube. The bezoar was removed endoscopically, and analysis identified SZC as its primary constituent. The authors considered impaired gastric motility, an acidic gastric environment, and limited hydration likely contributors.
What made this case unusual
The bezoar formed from SZC after nasogastric administration, with analysis confirming the drug as its primary constituent.
Diagnostic / clinical pearl
In a critically ill patient receiving SZC who develops a gastric mass, consider a drug-related bezoar; endoscopic removal and analysis can confirm its composition.
Why it matters
The report highlights a potential gastrointestinal complication of SZC therapy and the authors’ call for imaging monitoring and careful gastrointestinal management.